Provider Demographics
NPI:1073987111
Name:BAY AREA TRANSITIONAL CLINIC PLLC
Entity Type:Organization
Organization Name:BAY AREA TRANSITIONAL CLINIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:F
Authorized Official - Last Name:MERRITT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:409-655-2770
Mailing Address - Street 1:6608 GULF FWY STE 100
Mailing Address - Street 2:
Mailing Address - City:LA MARQUE
Mailing Address - State:TX
Mailing Address - Zip Code:77568-4095
Mailing Address - Country:US
Mailing Address - Phone:409-655-2770
Mailing Address - Fax:844-234-6011
Practice Address - Street 1:6608 GULF FWY STE 100
Practice Address - Street 2:
Practice Address - City:LA MARQUE
Practice Address - State:TX
Practice Address - Zip Code:77568-4095
Practice Address - Country:US
Practice Address - Phone:409-655-2770
Practice Address - Fax:844-234-6011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-29
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty